Advanced Nutrition and Dietetics in Diabetes E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: Advanced Nutrition and Dietetics (BDA)
• Sprache: Englisch

Seitenzahl: 871

Veröffentlichungsjahr: 2015

Beschreibung

Published on behalf of The British Dietetic Association, Advanced Nutrition and Dietetics in Diabetes is an exploration of the evidence and practice of nutrition in diabetes, offering a global view of the lifestyle interventions for the prevention and management of diabetes, including management of complications and special population groups. With internationally recognised authors, this book applies the rigour of evidence-based medicine to important enduring topics in diabetes, such as:

• public health efforts at diabetes prevention
• formulating nutritional guidelines for diabetes
• carbohydrates and the glycaemic index
• the management of diabetes in older people

The authors draw on their research and practical experience to offer sound guidance on best practice, ensuring that interventions are both scientifically secure and effective.

ABOUT THE SERIES

Dietary recommendations need to be based on solid evidence, but where can you find this information? The British Dietetic Association and the publishers of the Manual of Dietetic Practice present an essential and authoritative reference series on the evidence base relating to advanced aspects of nutrition and diet in selected clinical specialties. Each book provides a comprehensive and critical review of key literature in its subject.  Each covers established areas of understanding, current controversies and areas of future development and investigation, and is oriented around six key themes:

• Disease processes, including metabolism, physiology, and genetics
• Disease consequences, including morbidity, mortality, nutritional epidemiology and patient perspectives
• Nutritional consequences of diseases
• Nutritional assessment, drawing on anthropometric, biochemical, clinical, dietary, economic and social approaches
• Clinical investigation and management
• Nutritional and dietary management
• Trustworthy, international in scope, and accessible, Advanced Nutrition and Dietetics is a vital resource for a range of practitioners, researchers and educators in nutrition and dietetics, including dietitians, nutritionists, doctors and specialist nurses.

Leseprobe

Table of Contents

Cover

Title Page

Preface

Foreword

Editor biographies

Contributors

Abbreviations

SECTION 1: Background

Chapter 1.1: Prevalence, public health aspects and prevention of diabetes

1.1.1 Prevalence

1.1.2 Pre-diabetes

1.1.3 Public health aspects

1.1.4 Prevention

References

Chapter 1.2: Diagnostic criteria and classification of diabetes

1.2.1 Diagnostic criteria

1.2.2 Classification

References

SECTION 2: Dietary principles of diabetes

Chapter 2.1: Historical perspectives of dietary recommendations for diabetes

2.1.1 From early times to the seventeenthth century

2.1.2 Eighteenth and nineteenth centuries

2.1.3 Twentieth century

2.1.4 Dietary management of type 2 diabetes

2.1.5 Carbohydrate counting and exchanges

2.1.6 Glycaemic index

2.1.7 Development of nutritional guidelines for diabetes

2.1.8 Guidelines for low and middle income ountries

2.1.9 Guidelines for children and adolescents

2.1.10 A change in emphasis

2.1.11 Summary

References

Chapter 2.2: Nutritional guidelines for diabetes

2.2.1 Effectiveness of diabetes nutrition therapy

2.2.2 Diabetes nutrition therapy and macronutrients

2.2.3 Conclusion

References

Chapter 2.3: Carbohydrates

2.3.1 Introduction

2.3.2 Adverse effects of fructose: potential metabolic pathways

2.3.3 Contributors to the adverse effects of fructose

2.3.4 Conclusion

References

Chapter 2.4: Glycaemic index and glycaemic load in diabetes

2.4.1 Introduction

2.4.2 Measurement of glycaemic index and glycaemic load

2.4.3 Factors affecting glycaemic index and glycaemic load

2.4.4 GI, GL and diabetes

2.4.5 GI, GL and obesity

2.4.6 Metabolic effects of low glycaemic index and glycaemic load diets

2.4.7 GI and GL in real life situations

2.4.8 Conclusion

References

SECTION 3: Type 1 diabetes

Chapter 3.1: Epidemiology and pathogenesis of type 1 diabetes

3.1.1 Epidemiology

3.1.2 Pathogenesis of type 1 diabetes

3.1.3 Environmental Triggers

3.1.4 Summary

References

Chapter 3.2: Clinical management of type 1 diabetes

3.2.1 Introduction

3.2.2 Clinical presentation

3.2.3 Medical management of hyperglycaemia

3.2.4 Cardiovascular risk and type 1 diabetes

3.2.5 Hypoglycaemia

3.2.6 Conclusion

References

Chapter 3.3: Nutritional management of glycaemia in type 1 diabetes

3.3.1 Introduction

3.3.2 Nutrition and glucose management – the evidence

References

Chapter 3.4: Diet, education and behaviour in type 1 diabetes

3.4.1 Introduction

3.4.2 Education

3.4.3 Summary

References

Chapter 3.5: Lifestyle issues and type 1 diabetes – physical activity, alcohol and recreational drugs

3.5.1 Introduction

3.5.2 Physical activity

3.5.3 Alcohol

3.5.4 Recreational and prescription drug use

References

Useful websites

SECTION 4: Type 2 diabetes

Chapter 4.1: Epidemiology, aetiology and pathogenesis of type 2 diabetes

4.1.1 Epidemiology

4.1.2 Aetiology and pathogenesis

4.1.3 Conclusion

References

Chapter 4.2: Clinical management of hyperglycaemia in type 2 diabetes

4.2.1 Introduction

4.2.2 Multiple-risk-factor approach to treatment

4.2.3 Treatment of hyperglycaemia

4.2.4 Implementation strategies

4.2.5 Hypoglycaemia

4.2.6 Conclusions

References

Chapter 4.3: Nutritional management of glycaemia in type 2 diabetes

4.3.1 Nutrition therapy

4.3.2 Weight control

4.3.3 Carbohydrate

4.3.4 Fibre (non-starch polysaccharides)

4.3.5 Protein

4.3.6 Fat

4.3.7 Nutritional supplements

4.3.8 Physical activity

4.3.9 Progression of type 2 diabetes

References

Chapter 4.4: Obesity and cardiovascular risk in type 2 diabetes

4.4.1 Introduction

4.4.2 Structural changes to the heart in obesity

4.4.3 Obesity and dysrhythmias

4.4.4 Obesity and hypertension

4.4.5 Obesity and dyslipidemia

4.4.6 Obesity insulin resistance and inflammation

4.4.7 Effects of weight loss on CV risk

4.4.8 Obesity paradox

4.4.9 What is the best dietary composition for the prevention of CVD?

4.4.10 Mediterranean diet

4.4.11 Summary

References

Chapter 4.5: Diet, education and behaviour in type 2 diabetes

4.5.1 Diet and behaviour education

4.5.2 One-to-one education

4.5.3 Group-based education

4.5.4 Interventions that support behaviour change

4.5.5 Resources that support behaviour change

4.5.6 Healthcare professional communication skills that support behaviour change

References

Chapter 4.6: Lifestyle issues and type 2 diabetes – physical activity and alcohol

4.6.1 Introduction

4.6.2 Physical activity

4.6.3 Alcohol

References

Chapter 4.7: Public health and the prevention of type 2 diabetes

4.7.1 Risk factors for type 2 diabetes

4.7.2 Screening for type 2 diabetes

4.7.3 Diabetes prevention

References

SECTION 5: Pregnancy and diabetes

Chapter 5.1: Epidemiology, aetiology and pathogenesis of diabetes in pregnancy

5.1.1 Introduction

5.1.2 Epidemiology

5.1.3 Aetiology

5.1.4 Risk factors

References

Chapter 5.2: Clinical management of diabetes in pregnancy

5.2.1 Introduction

5.2.2 Pre-conception care

5.2.3 Antenatal care

5.2.4 Perinatal care

5.2.5 Postnatal care

5.2.6 Screening for diabetes in pregnancy

5.2.7 Conclusion

References

Chapter 5.3: Lifestyle management of diabetes in pregnancy

5.3.1 Introduction

5.3.2 Pre-pregnancy

5.3.3 Obesity

5.3.4 Nutritional management of diabetes in pregnancy

5.3.5 Physical activity

5.3.6 Lactation

5.3.7 Summary

References

SECTION 6: Diabetes in children and adolescents

Chapter 6.1: Epidemiology, aetiology and pathogenesis of childhood diabetes

6.1.1 Introduction

6.1.2 Epidemiology of childhood diabetes

6.1.3 Aetiology, classification and pathogenesis

6.1.4 Pathogenesis of diabetes in childhood

6.1.5 Conclusion

References

Chapter 6.2: Clinical management of diabetes in children and adolescents

6.2.1 Introduction

6.2.2 Insulin management

6.2.3 Diabetes emergencies

6.2.4 Insulin pump therapy

6.2.5 Type 2 diabetes

References

Chapter 6.3: Lifestyle management of childhood diabetes

6.3.1 Introduction

6.3.2 Type 1 diabetes

6.3.3 Type 2 diabetes

6.3.4 Summary

References

SECTION 7: Diabetes in older people

Chapter 7.1: Epidemiology, aetiology, pathogenesis and management of diabetes in older people

7.1.1 Introduction

7.1.2 Epidemiology

7.1.3 Incidence and prevalence

7.1.4 Aetiology and pathogenesis

7.1.5 Risk factors

7.1.6 Screening

7.1.7 Prevention

7.1.8 Conclusion

References

Chapter 7.2: Lifestyle management, including nutrition, of diabetes in older people

7.2.1 Introduction

7.2.2 Brief overview of the pathogenesis of diabetes in older people

7.2.3 Clinical features of diabetes in older people

7.2.4 Overview of management strategies

7.2.5 Management guidelines

7.2.6 General health care

7.2.7 Blood glucose monitoring and blood glucose targets

7.2.8 Nutrition and activity

7.2.9 Medicines: the need for pharmacovigilance

7.2.10 Surgical care

7.2.11 Annual health assessment

7.2.12 Summary

References

SECTION 8: Diabetes in ethnic groups

Chapter 8.1: Epidemiology, aetiology and pathogenesis of diabetes in ethnic groups

8.1.1 Introduction

8.1.2 Epidemiology

8.1.3 Aetiology

8.1.4 Pathogenesis

8.1.5 Conclusion

References

Chapter 8.2: Clinical management of diabetes in ethnic groups

8.2.1 Introduction

8.2.2 Classification and atypical presentation

8.2.3 Assessing glycaemic control

8.2.4 Glycaemic control management

8.2.5 Clinical management of complications

8.2.6 Summary

References

Chapter 8.3: Lifestyle management of diabetes in ethnic groups

8.3.1 Introduction

8.3.2 Nutritional considerations in ethnic groups

8.3.3 Cultural barriers to lifestyle modifications

8.3.4 Designing lifestyle interventions for ethnic minority groups

8.3.5 Culturally tailored care in practice

8.3.6 Recommendations for future research, policy and practice

8.3.7 Conclusion

References

SECTION 9: Complications and comorbidities of diabetes

Chapter 9.1: Microvascular disease (renal) and diabetes

9.1.1 Introduction

9.1.2 Early diabetic CKD (stages 1–3) management

9.1.3 Nutritional requirements

9.1.4 Nutritional assessment

9.1.5 Late diabetic CKD (stages 4–5) management

9.1.6 Future developments

References

Chapter 9.2: Macrovascular disease and diabetes

9.2.1 Epidemiology of macrovascular disease in diabetes

9.2.2 Effects of intervention on glycaemic control

9.2.3 Effects of intervention on other cardiovascular risk factors

9.2.4 Conclusions

References

Chapter 9.3: Coeliac disease and diabetes

9.3.1 Introduction

9.3.2 Clinical onset and symptoms

9.3.3 Diagnosis

9.3.4 Treatment of coeliac disease

9.3.5 Dietary sources of gluten

9.3.6 Diet in diabetes

References

Chapter 9.4: Disorders associated with insulin resistance

9.4.1 Introduction

9.4.2 Polycystic ovary syndrome

9.4.3 Non-alcoholic fatty liver disease

9.4.4 HIV

References

Recommended website

Chapter 9.5: Cystic fibrosis-related diabetes

9.5.1 Introduction

9.5.2 Epidemiology of CFRD

9.5.3 Pathophysiology of CFRD

9.5.4 Screening

9.5.5 Diagnosis

9.5.6 Clinical consequences of CFRD

9.5.7 Management of CFRD

9.5.8 Conclusion

9.5.9 Unanswered questions

References

Chapter 9.6: Diabetic gastroparesis

9.6.1 Introduction

9.6.2 Prevalence

9.6.3 Risk factors for DGP

9.6.4 Diagnosis

9.6.5 Effects of DGP

9.6.6 Treatment of DPG

9.6.7 Glycaemic control

9.6.8 Dietary treatment

References

Chapter 9.7: Nutrition support in diabetes

9.7.1 Introduction

9.7.2 Standards of care

9.7.3 Oral nutrition support

9.7.4 Enteral nutrition

9.7.5 Medication changes

9.7.6 Total parenteral nutrition

9.7.7 Discharge from hospital

9.7.8 Conclusion

References

Further reading

Index

End User License Agreement

List of Tables

Chapter 1.1

Table 1.1.1 Regional estimates for diabetes (20–79 age group), 2010 and 2030

Chapter 2.1

Table 2.1.1 Historical changes in the nutritional management of diabetes (Sanders, 2001 [4]; Canadian Diabetic Association, 2008 ADA, 2008 [16]; Diabetes UK, 2011 [18]; Tattersall, 2009 [2])

Chapter 2.4

Table 2.4.1 Glycaemic index and glycaemic load classification

Table 2.4.2 Comparison of the glycaemic index and glycaemic load of some common foods

Table 2.4.3 Practical application of the glycaemic index – low, medium and high GI foods

Chapter 3.2

Table 3.2.1 ADA and AACE guidelines for target HbA1c.

Table 3.2.2 Characteristics of insulin for treating type 1 diabetes.

Chapter 3.3

Table 3.3.1 Summary of key recommendations for carbohydrate management in type 1 diabetes

Chapter 3.5

Table 3.5.1 Restrictions on sports for people with type 1 diabetes [2]

Table 3.5.2 Blood glucose response and circulating insulin levels

Table 3.5.3 Activity type and implications for type 1 diabetes [7]

Table 3.5.4 General exercise guidelines for type 1 diabetes

Table 3.5.5 General insulin dose reductions for endurance sports [5]

Chapter 4.2

Table 4.2.1 Type 2 diabetes. The symptoms and conditions that need preventing, addressing and, if necessary, treating

Table 4.2.2 Characteristics of insulin preparations to treat diabetes

Chapter 4.5

Table 4.5.1 Comparison of diet and behaviour interventions

Chapter 4.6

Table 4.6.1 Examples of aerobic and resistance training

Table 4.6.2 Levels of exercise recommended for weight loss and prevention of weight regain for adults [3]

Chapter 4.7

Table 4.7.1 Meta-analyses examining food intake relating to risk of Type 2 diabetes

Table 4.7.2 Selected screening and predictive tools for detecting undiagnosed type 2 diabetes

Table 4.7.3 Diabetes prevention studies with lifestyle change in diverse populations

Chapter 5.2

Table 5.2.1 Interventions to maintain glycaemia in

type 1 diabetes

,

type 2 diabetes

and gestational diabetes

Table 5.2.2 Target glucose concentrations during pregnancy

Table 5.2.3 Diagnosis of gestational diabetes

Chapter 6.1

Table 6.1.1 Aetiological classification of glycaemic disorders adapted from International Society for Pediatric and Adolescent Diabetes consensus guidelines 2009

Chapter 6.3

Table 6.3.1 Summary of strategies to support exercise management in children with type 1 diabetes

Chapter 7.2

Table 7.2.1 European Geriatrics Society and the International Diabetes Federation blood glucose, blood pressure and lipid targets for healthy and frail older people

Table 7.2.2 Overview of some of the factors that affect management decisions in older people with diabetes

Chapter 8.1

Table 8.1.1 Diabetes prevalence, by ethnicity, in the United States

Chapter 8.2

Table 8.2.1 Retrospective studies in atypical ketosis prone diabetes in different ethnic groups

Chapter 8.3

Table 8.3.1 Glycaemic index of South Asian foods

Table 8.3.2 Dietary modification of South Asian diet for diabetes

Table 8.3.3 Dietary modification of African-Caribbean diet for diabetes

Chapter 9.1

Table 9.1.1 Chronic kidney disease classification [3]

Table 9.1.2 Summary of the 2012 KDOQI Diabetes Guidelines

Table 9.1.3 Nutritional targets in CKD based upon NKF/KDOQI (2007), Renal Association Guideline (2011) [6], NICE Guidelines (2008) and British Dietetic Association Renal Nutrition Group (2011)

Table 9.1.4 The dietetic assessment of CKD stage 5 patients with or without diabetes

Chapter 9.2

Table 9.2.1 Current guidance on HbA1c targets and treatment interventions to achieve glucose control

Table 9.2.2 Current guidance blood pressure targets and treatment regimens

Table 9.2.3 Current guidance for lipid profile targets and treatment options

Table 9.2.4 Current guidance for antiplatelet therapy

Table 9.2.5 Current guidance for lifestyle interventions for patients at risk of diabetes

Chapter 9.3

Table 9.3.1 Foods permitted and not permitted on a gluten free diet

Chapter 9.5

Table 9.5.1 Characteristics of cystic fibrosis-related diabetes, type 1 and type 2 diabetes

Table 9.5.2 Classification of glucose tolerance abnormalities in cystic fibrosis

Table 9.5.3 Nutritional management of cystic fibrosis-related diabetes, type 1 and type 2 diabetes [34]

Chapter 9.6

Table 9.6.1 Grades of severity of gastroparesis

List of Illustrations

Chapter 2.3

Figure 2.3.1 Potential mechanism by which consumption of fructose affects lipid metabolism and insulin sensitivity

:

Unregulated fructose uptake by the liver, mediated primarily by phosphorylation via fructokinase (

a

), leads to increased DNL (

b

). DNL increases the intra-hepatic lipid supply directly, via synthesis of fatty acids (

d

), and indirectly, by inhibiting fatty acid oxidation (

c

)(

e

). Increased levels of intra-hepatic lipid content promote VLDL production and secretion (

f

), which leads to dyslipidemia (

g

) and increased CVD risk (

h

). Increased levels of hepatic lipids may also promote hepatic insulin resistance by increasing levels of DAG, which activates nPKC and leads to serine phosphorylation of the insulin receptor and IRS-1 and impaired insulin action (

i

). Increased exposure to circulating triglyceride may lead to the accumulation of intramyocellular lipid in skeletal muscle (

j

), impaired DAG-mediated insulin signalling, and whole body insulin resistance (

k

). This sequence of events is likely to be exacerbated by hepatic insulin resistance, uric acid production, and inflammatory factors. Due to selective insulin resistance, DNL is even more strongly activated in the insulin resistant liver DNL (

l.

), which has the potential to generate a vicious cycle (black arrows). This cycle would be expected to further exacerbate VLDL production and secretion by increasing the intra-hepatic lipid supply. Hepatic insulin resistance also exacerbates VLDL production/secretion by increasing apoB availability and MTP expression (

m

). The unregulated fructose uptake by the liver, mediated by fructokinase, also leads to increased production of uric acid via the purine degradation pathway (

n

). This pathway may indirectly contribute to the liver lipid supply by concurrently generating mitochondrial oxidants that up-regulate DNL (

o

). Uric acid may also promote fructose uptake into the liver by up-regulating expression of fructokinase (

p

) and may contribute to the accumulation of lipid in the liver by inhibiting AMP-activated kinase, an activator of fatty acid oxidation (

q

). Inflammatory responses to fructose may impair hepatic insulin signalling (

r

) or increase hepatic lipid levels (

s

). These may be mediated by fructose-induced increases of visceral adipose which increase MCP-1 and PAI-1 (

t

), or fructose exposure to intestine which increases translocation of bacterial endotoxin (

u

), or exposure to hepatocytes which increases JNK activation (

v

)

Chapter 3.1

Figure 3.1.1 Incidence rates of type 1 diabetes with onset in the age range 0–29 years in 1996–1997 for three European countries.

Figure 3.1.2 Top 10 countries incidence rate for type 1 diabetes in children (0–14 years). Only countries where studies have been carried out in that country are included.

Figure 3.1.3 Incidence of type 1 diabetes in children 0–14 years worldwide (cases per 100 000 population per year.

Figure 3.1.4 Immunological basis for type 1 diabetes.

Chapter 3.2

Figure 3.2.1 This cartoon illustrates the key components of an insulin pump device as would be worn by a patient. A reservoir pumps insulin through tubing into a subcutaneous catheter at a predetermined rate.

Chapter 3.5

Figure 3.5.1 The contribution of energy sources used depending on the duration of the activity

Chapter 4.1

Figure 4.1.1 Prevalence (%) of diabetes in adults (20–79 years), 2013.

Figure 4.1.2 Dynamic systems in the beta-cell. The boxed items are pathological mechanisms variously proposed to explain the beta-cell dysfunction

Figure 4.1.3 Community interventions can be cost saving. Labelling, advertising and prompts all help to reduce the risks of diabetes

Chapter 4.2

Figure 4.2.1 Glycaemic goals need to be personalised for each patient. A young, highly motivated patient with no comorbidity should have stringent goals. By contrast, an elderly patient with low life expectancy and poor health-care support may need less stringent control. The lines on each triangle show how each of these characteristics may have an influence on where the final target is set

Figure 4.2.2 Therapy of type 2 diabetes is based on a background of healthy eating, weight control and increased physical activity. Beyond this, metformin is usually the first line agent and two-drug combinations or three-drug combinations can be used. When β-cell failure becomes severe, insulin is the only option

Chapter 7.1

Figure 7.1.1 Pathogenesis of type 2 diabetes in older people

Figure 7.1.2 Main risk factors and prevention of type 2 diabetes in older people

Chapter 8.1

Figure 8.1.1 Prevalence of doctor-diagnosed diabetes, by sex, within minority ethnic groups aged 55 years and over

Figure 8.1.2 Prevalence of diabetes for ethnic groups of the US compared to their countries of origin.

Figure 8.1.3 Prevalence of diabetes in various US ethnic groups (Mokdad et al., 2000, 2001).

Guide

Cover

Table of Contents

Begin Reading

Pages

i

ii

iii

vii

viii

ix

x

xi

xii

xiii

xiv

xv

1

3

4

5

6

7

8

9

10

11

13

15

16

17

18

19

20

21

22

23

24

25

26

27

28

29

30

31

32

33

34

35

36

37

38

39

40

41

42

43

44

45

46

47

48

49

51

53

54

55

56

57

58

59

60

61

62

63

64

65

66

67

68

69

70

71

72

73

74

75

76

77

78

79

80

81

82

83

84

85

86

87

88

89

90

93

95

96

97

98

99

100

101

102

103

104

105

106

107

108

109

110

111

112

113

114

115

116

117

118

119

120

121

122

123

124

125

126

127

128

129

130

131

132

134

135

136

137

138

139

140

141

142

143

144

145

146

147

148

149

150

151

152

153

154

155

156

157

159

160

161

162

163

164

165

166

167

168

169

170

171

172

173

174

175

176

177

178

179

180

181

183

185

186

187

188

189

190

191

192

193

194

195

196

197

198

199

200

201

202

203

204

205

207

209

210

211

212

213

214

215

216

217

218

219

220

221

222

223

224

225

226

227

228

229

231

232

233

234

235

236

237

238

239

240

241

242

243

244

245

246

247

248

249

250

251

252

253

254

255

256

257

258

259

260

261

263

264

265

266

267

268

269

270

271

272

273

274

275

276

277

278

279

280

281

282

283

284

285

286

287

288

289

290

291

292

293

294

295

296

297

298

299

300

301

303

304

305

306

307

308

309

310

311

312

313

314

315

316

317

318

319

320

321

322

323

324

325

326

327

328

329

330

331

332

333

Advanced Nutrition and Dietetics in Diabetes

Editors

Louise Goff PhD RD

Pamela Dyson PhD RD

Series Editor

Kevin Whelan PhD RD

This edition first published 2016 © 2016 by John Wiley & Sons, Ltd

Registered OfficeJohn Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK

Editorial Offices9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK1606 Golden Aspen Drive, Suites 103 and 104, Ames, Iowa 50010, USA

For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley-blackwell.

The right of Louise Goff and Pamela Dyson to be identified as the authors of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.

All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.

Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.

The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.

Library of Congress Cataloging-in-Publication Data

Advanced nutrition and dietetics in diabetes / edited by Louise Goff & Pamela Dyson.  p. ; cm. – (Advanced nutrition and dietetics (BDA)) Includes bibliographical references and index.

 ISBN 978-0-470-67092-7 (pbk.)I. Goff, Louise, editor. II. Dyson, Pamela, editor. III. Series: Advanced nutrition and dietetics (BDA)[DNLM: 1. Diabetes Mellitus–diet therapy. 2. Diabetic Diet. 3. Health Behavior. 4. Life Style. 5. Nutrition Therapy. WK 818]j RC662 616.4′620654–dc23

        2015022542

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

ADVANCED NUTRITION AND DIETETICS BOOK SERIES

Dietary recommendations need to be based on solid evidence, but where can you find this information? The British Dietetic Association and the publishers of the Manual of Dietetic Practice present an essential and authoritative reference series on the evidence base relating to advanced aspects of nutrition and dietetics in selected clinical specialties. Each book provides a comprehensive and critical review of key literature in the area. Each covers established areas of understanding, current controversies and areas of future development and investigation, and is oriented around six key themes:

Disease processes, including metabolism, physiology and genetics

Disease consequences, including morbidity, mortality and patient perspectives

Clinical investigation and management

Nutritional consequences of disease

Nutritional assessment, including anthropometric, biochemical, clinical, dietary, economic and social approaches

Nutritional and dietary management of disease

Trustworthy, international in scope, and accessible, Advanced Nutrition and Dietetics is a vital resource for a range of practitioners, researchers and educators in nutrition and dietetics, including dietitians, nutritionists, doctors and specialist nurses.

Preface

Diabetes has been with us since ancient times, and the first mention of an illness that could be diabetes was recorded in an Egyptian papyrus of 1500 BC. A simplistic definition of diabetes is that of a disease typified by excessively high blood glucose concentrations, but this conceals the true nature of diabetes as a complex biochemical disorder affecting carbohydrate, fat and protein metabolism. Treatment of diabetes is multifactorial and aims to reduce both short- and long-term complications of the disease while maintaining quality of life. Diabetes belongs to the group of diseases that cannot be managed by medication alone, and lifestyle factors, including diet and physical activity, are fundamental to successful management. Dietary advice has been subject to various fashions over the years from low to high carbohydrate (and back) and each new approach has been greeted with almost equal amounts of enthusiasm and criticism. The fundamental question for all health professionals concerned with the management of diabetes is – what is the best diet for diabetes?

Evidence-based medicine (and lifestyle advice) is the cornerstone of successful management, and although there are numerous randomized controlled trials indicating the efficacy and safety of most medications used to treat diabetes, this is not always true of lifestyle interventions. Many studies designed to investigate the effects of lifestyle and dietary interventions are not well-designed and there are issues with small numbers of subjects, lack of comparison or control groups, study design and intervention, data quality, data reporting and target populations. It is impossible to conduct randomized, controlled trials in free-living populations over the periods of time required for unambiguous results, and in many cases short-term trials using surrogate end-points are the only evidence available. Despite this, many national and international diabetes associations now publish evidence-based guidelines and recommendations for the dietary management of diabetes, although most of these guidelines identify areas where there is little evidence and recommendations are made based on consensus opinion.

This book is designed to offer both evidence for and the practical aspects of the nutritional management of diabetes, and offers a global view of the lifestyle interventions for the prevention and management of diabetes, including management of complications and special groups. Recognized authorities from around the world have shared their expertise in areas such as the management of diabetes in older people, the glycaemic index, public health and prevention and formulating nutritional guidelines. The book is divided into nine different sections, each addressing a particular aspect of diabetes and each providing a critical review of key literature in the area with an emphasis on translating evidence into practice. The epidemiology, aetiology and clinical management of diabetes are addressed, with an emphasis on lifestyle management, and specifically diet and nutrition, in all areas of the treatment and prevention of diabetes.

This book is aimed at those who work at an advanced level in diabetes, including clinicians, researchers and educators, and is intended for the multi-disciplinary team, including specialist dietitians, diabetes specialist nurses, physicians and psychologists. It will also appeal to general dietitians who wish to learn more about diabetes, and to those undertaking Masters degrees in dietetics, nutrition, medicine or nursing with a specific diabetes component. It is a useful reference and resource for those teaching diabetes at any level.

Louise Goff PhD RDSenior Lecturer in Nutritional SciencesKing's College LondonPamela Dyson PhD RDResearch DietitianUniversity of OxfordEditorsAdvanced Nutrition and Dietetics in Diabetes

This book is the second title in a series commissioned as part of a major initiative between the British Dietetic Association and the publishers Wiley. Each book in the series provides a comprehensive and critical review of the key literature in a clinical area. Each book is edited by one or more experts who have themselves undertaken extensive research and published widely in the relevant topic area. Each book chapter is written by experts drawn from an international audience and from a variety of disciplines as required of the relevant chapter (e.g. dietetics, medicine, public health, basic sciences). Future titles in the series will cover areas including obesity and nutritional support.

The book editors and I are proud to present the second title in the series: Advanced Nutrition and Dietetics in Diabetes. We hope that it impacts on health professionals’ understanding and application of nutrition and dietetics in the prevention and management of diabetes and improves outcomes and reduces complications for such patients.

Kevin Whelan PhD RDProfessor of DieteticsKing’s College LondonSeries EditorAdvanced Nutrition and Dietetics Book Series

Foreword

Diabetes management is complex and requires a multidisciplinary team approach, including a wide range of healthcare professionals as well as people with diabetes and their carers. Diet and lifestyle advice form the cornerstone of diabetes self-management, education and counselling, and for most patients with diabetes, this is one of their main concerns. It is therefore crucial that all healthcare professionals, not just dietitians, involved in diabetes care have a good knowledge of the role of diet and skills in advising patients about their lifestyle.

This book is a comprehensive text and reviews concisely and succinctly the literature relating to diabetes pathophysiology and aetiology and the latest evidence on the role of diet in the prevention and management of the many different types and presentations of diabetes.

This book has contributions from leading clinicians, dietitians and researchers in the field of diabetes and covers diabetes in more depth and breadth than other diet-oriented texts; included are sections on diabetes in older adults, diabetes in ethnic minority groups, diabetes in pregnancy, diabetes and coeliac disease, cystic fibrosis-related diabetes and gastroparesis as well, focusing clearly on both type 1 and type 2 diabetes.

I would recommend Advanced Nutrition and Dietetics in Diabetes as essential reading for not only dieticians but also physicians, nurses and scientists who want to – and indeed need to – know about the role of diet in diabetes management.

Professor Sir George AlbertiEmeritus Professor of Medicine, University of NewcastleSenior Research Investigator, Endocrinology & Metabolism Group, Imperial College LondonVisiting Professor, Division of Diabetes & Nutritional Sciences, King’s College London